ICML 2023 | The safety of venetoclax, ibrutinib, prednisone, obinutuzumab, and lenalidomide (ViPOR) in R/R MCL

ViPOR or venetoclax, ibrutinib, prednisone, obinutuzumab, and lenalidomide is a novel combination targeted therapy regimen that was developed based on significant preclinical synergy seen mainly in ABC-DLBCL cell lines. All of the agents are very active clinically as monotherapy in mantle cell lymphoma. So it was a very natural decision for the trial to open up a mantle cell cohort of that study. So we’ve been enrolling patients now for several years on that cohort. Again, based on the synergy seen in large cell and the clinical activity in mantle cell. And overall, we showed that the regimen was very safe in patients with mantle cell of all ages. There was no tumor lysis syndrome observed with the venetoclax ramped up on cycle two over a 12-day period and the main toxicity was hematologic. But high-grade hematologic toxicity occurred in less than a quarter of cycles for patients. Unlike other approved targeted therapies or doublet or triplet therapy, the ViPOR regimen was modeled after cytotoxic chemotherapy where all of the agents are given in non-continuous cycles. So two weeks of study drug followed by one week break of all study agents for a fixed-duration of only 18 weeks or four months. And following treatment, there was no maintenance. So it was really designed as a multi agent combination targeted therapy regimen that could drive the lymphoma into a deep and durable remission without the need for maintenance, which again is very different from some of the approved agents in the relapsed setting.